Manifestaciones clínicas e histopatológicas de la eritroplasia bucal en pacientes fumadores de tabaco

Fundamento la eritroplasia es la lesión precancerosa más agresiva de la cavidad oral, con un gran potencial de transformación maligna. Al momento de practicar la biopsia y analizar la muestra, puede aparecer una displasia severa o un carcinoma invasivo. Objetivo describir las manifestaciones clínicas e histopatológicas de la eritroplasia bucal en pacientes fumadores activos de tabaco. Métodos se realizó un estudio descriptivo y transversal, con 12 fumadores diagnosticados clínica e histopatológicamente con eritroplasia bucal, atendidos en la consulta estomatológica del Policlínico de Especialidades del Hospital Saturnino Lora Torres, de Santiago de Cuba. Para la recolección del dato primario se confeccionó una encuesta con las variables: edad, sexo, diagnóstico clínico, tiempo en el hábito de fumar, diferentes formas de consumir tabaco, localización anatómica y estudio histopatológico de la enfermedad. Resultados prevaleció el sexo masculino, el grupo etario de 60 y más años, y los fumadores convencionales de 21 y más años. El infiltrado inflamatorio crónico intenso y la displasia epitelial severa resultaron los cambios hísticos más comunes. Los signos displásicos tisulares mayormente implicados fueron la alteración de los clavos interpapilares, pérdida de la polaridad de las células basales e hiperplasia de las células del estrato basal; mientras que los displásicos citológicos más relevantes resultaron la hipercromasia de núcleos y nucleolos, el pleomorfismo nuclear y el aumento de la relación núcleo-citoplasma, siendo el paladar blando el sitio más frecuente. Conclusiones todos los pacientes fumadores mostraron lesiones eritroplásicas al examen clínico bucal, lo cual fue confirmado por estudio histopatológico.

Foundation erythroplasia is the most aggressive precancerous lesion in the oral cavity, with great potential for malignant transformation. At the time of performing the biopsy and analyzing the sample, severe dysplasia or invasive carcinoma may appear. Objective to describe the clinical and histopathological manifestations of oral erythroplasia in patients who are active tobacco smokers. Methods a descriptive and cross-sectional study was carried out, with 12 smokers clinically and histopathologically diagnosed with oral erythroplasia, attended in the Specialties Polyclinic stomatological consultation of the Saturnino Lora Torres Hospital, in Santiago de Cuba. For the collection of the primary data, a survey was made with the variables: age, sex, clinical diagnosis, time in the smoking habit, different ways of consuming tobacco, anatomical location and histopathological study of the disease. Results the male sex, the age group of 60 years old and over, and conventional smokers of 21 and over prevailed. Intense chronic inflammatory infiltrate and severe epithelial dysplasia were the most common tissue changes. The tissue dysplastic signs most involved were alteration of the interpapillary nails, loss of polarity of the basal cells, and hyperplasia of the basal layer cells; while the most relevant cytological dysplastics were hyperchromasia of nuclei and nucleoli, nuclear pleomorphism and increased nucleus-cytoplasm ratio, with the soft palate being the most frequent site. Conclusions all the smoking patients showed erythroplastic lesions on oral clinical examination, which was confirmed by histopathological study.

Consumo de tabaco en pacientes hospitalizados en Clínica Alemana de Santiago de Chile / Frequency of smoking among hospitalized patients

Background: Smoking is one of the most relevant public health problems worldwide and one of the main causes of preventable premature death. In-hospital treatment and subsequent follow-up are effective in terms of cessation. Aim: To determine the frequency of smoking habits among patients hospitalized at a private clinic in Santiago. Material and Methods: Hospitalized patients were invited to answer a structured and adapted questionnaire on smoking habits. Results: The survey was answered by 294 patients (56% women). Twenty three percent of respondents were smokers. Among smokers, 50% indicated a consumption from 1 to 5 cigarettes per day, 19% smoked during the first hour after waking, and 43% lived with another smoker in their home. Eighty three percent thought about quitting and made unsuccessful attempts to quit using different strategies. Conclusions: The percentage of smokers in this group of patients is lower than that reported in the national health survey. The high proportion of respondent that are attempted to quit and failed, justifies the availability of structured quitting programs at the hospital and follow-up strategies after discharge.

Cigarette Smoking Effect on Microhardness and Flexural Properties of Denture Base Resins

ABSTRACT Objective: To identify the tobacco effect on flexural properties and the microhardness of three acrylic resins. Material and Methods: Three resins were tested: two thermo-polymerizable acrylic resins (RMB 20 and BMS 014) and one autopolymerized acrylic resin. The 3-point bending and microhardness tests were carried out with a universal tensile-compression machine and a micro-Vickers hardness tester. The acrylic resin specimens have been exposed for 21 days to cigarette smoke in a smoking room. Their mechanical strength was compared to unexposed samples. Statistical analysis was performed using the data processing software SPSS Statistics 21.0. Results: The flexural properties of the resins were affected by cigarette smoke only in the case of Major Base 20® (drop in strength with p= 0.02; 0.6; 0.7 and in elastic modulus with p= 0.86; 0.74 and 0.85 for Major Base 20®, BMS 014® and Major Repair®). The cigarette smoke affected significantly microhardness for all groups (p<0.001). Conclusion: Cigarette smoking does not affect the flexural properties of the acrylic resin (BMS 014® and Major Repair® unlike Major Base 20®), but it does reduce the microhardness.

Why MBBS Students are Taking to Substance Abuse ? — A Retrospective Study on the Pattern and Causes of Substance Abuse among the MBBS Students of West Bengal

Background : Substance abuse is an important health hazard and also a major preventable cause of morbidity and mortality. This habit not only affects health, education and occupational career, but also incurs huge financial and social burden to the society specially when the doctors are involved in it. Aims and objectives : To estimate the prevalence of substance abuse, its pattern and causes among the MBBS students of West Bengal. Methods : A questionnaire based cross-sectional retrospective study was designed to collect data from the Medical Officers of the State to record their experience of substance abuse during their MBBS course. Results : The prevalence of substance abuse was 22% among the study participants. Smoking Tobacco was most common (16.67%). 76% of the subjects with substance abuse spend Rs1000 or less per month. The prevalence was 25% in upper class and 22.22% among those who belonged to lower class of socio-economic status as per BG Prasad Classification. Curiosity was the reason as per 34.5% of the subjects followed by depression (23.25%), peer pressure (13%) study pressure by 15%; media influence by 11%; to cope with home problems by 10.75% and parental influence by 2.25% of the study subjects. Conclusion : The institution should keep a Psychological Counselor who can guide the students who suffer from problems related to Depression, Peer pressure, Study pressure that may lead to substance abuse. Allotting, hobbies, sports and recreation would help in keeping away from substance abuse

O impacto das diversas formas de tabagismo nos acadêmicos da área da saúde / The impact of different forms of smoking on health academics

A Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) define a Doença Pulmonar Obstrutiva Crônica (DPOC) como um distúrbio progressivo e irreversível. Nessa patologia ocorre um processo inflamatório crônico frente a exposição a gases tóxicos, principalmente advindos do tabaco. O cigarro é responsável por matar mais de 8 milhões de consumidores por ano, isso corresponde a 50% dos usuários. Objetivo: estimar a prevalência do tabagismo e possíveis doenças no sistema respiratório entre acadêmicos. Métodos: Trata-se de uma pesquisa observacional do tipo transversal em que se aplicou questionários aos alunos da área da saúde da Universidade Cesumar. Todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido e eram maiores de 18 anos. A amostra foi composta por 336 estudantes, desta foram excluídas 43 respostas preenchidas de forma incorreta, restando 293 participantes. Os dados foram submetidos à estatística analítica e teste do qui-quadrado com nível de significância de 5%. Resultados: A prevalência do tabagismo foi de 26,96%, não fumantes são 62,46% e 10,58% são fumantes passivos. O dispositivo mais utilizado foi o cigarro eletrônico com 64,55% e o narguilé com 63,29%. Com relação a tentativa de suspender o uso, 36,71% relataram apresentar ansiedade. Os fumantes informaram ter infecções respiratórias frequentes, secreção, tosse e espirros com significância estatística (p<0,05). Pneumonia apresentou tendência crescente conforme maior tempo de tabagismo. Conclusão: Observou-se que a taxa de acadêmicos tabagistas é considerável, o tempo de uso varia de 3 a 5 anos e a maioria iniciou na adolescência sob influência de amigos

The Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) defines Chronic Obstructive Pulmonary Disease (COPD) as a progressive and irreversible disorder. In this pathology, there is a chronic inflammatory process due to exposure to toxic gases, mainly from tobacco. Cigarettes are responsible for killing more than 8 million consumers a year, this corresponds to 50% of users. Objective: to estimate the prevalence of smoking and possible diseases of the respiratory system among students. Methods: This is a cross-sectional observational research in which questionnaires were applied to students in the health area of the University Cesumar. All participants signed the Informed Consent Form and were over 18 years of age. The sample consisted of 336 students, from which 43 incorrectly filled answers were excluded, leaving 293 participants. Data were submitted to analytical statistics and the chi-square test with a significance level of 5%. Results: The prevalence of smoking was 26.96%, non-smokers are 62.46% and 10.58% are passive smokers. The most used device was the electronic cigarette with 64.55% and the hookah with 63.29%. Regarding the attempt to discontinue use, 36.71% reported having anxiety. Smokers reported having frequent respiratory infections, secretion, coughing and sneezing with statistical significance (p<0.05). Pneumonia showed an increasing trend with longer smoking time. Conclusion: It was observed that the rate of academic smokers is considerable, the time of use varies from 3 to 5 years and most started in teenage years under the influence of friends

Tobacco use among transgender and gender non-binary youth in Brazil / Uso de tabaco entre jovens transgêneros e não-binários do Brasil

Abstract Transgender and gender non-binary youth are particularly vulnerable to tobacco smoking and susceptible to smoking adverse health outcomes. That is, they are in special risk to start smoking and, after starting, they may face worse outcomes when comparing to their cisgender peers. Therefore, the present study aims to evaluate factors associated with tobacco use among transgender and gender non-binary youth. Brazilian youth aged 16 to 25 who identify as transgender or gender non-binary answered an online questionnaire. Poisson regression with robust variance was run to predict smoking cigarettes based on individual and environmental factors. 14.1% of 206 youth reported smoking cigarettes daily, whereas 9.3% of participants reported smoking e-cigarettes occasionally. Drug use, lack of social support, deprivation, discrimination, the wait for medical gender-affirming procedures and being outside school were associated with smoking cigarettes. Contextual and individual factors should be further explored in causal analysis and taken into consideration when planning smoking prevention and cessation interventions for transgender and gender non-binary youth.

Resumo Jovens transgêneros e não-binários são particularmente vulneráveis ao tabagismo e suscetíveis a seus malefícios a saúde. Ou seja, esses grupos estão em especial risco para começar a fumar e, após o início, tendem a apresentar resultados piores quando comparados a seus pares cisgêneros. Sendo assim, o presente estudo tem como objetivo avaliar fatores associados ao uso do tabaco em jovens transgêneros e não-binários. Jovens brasileiros, com idade entre 16 e 25 anos, que se identificam como transgêneros ou não-binários responderam um questionário on-line. Uma Regressão de Poisson com variância robusta foi realizada para predizer o consumo de cigarros com base em fatores individuais e ambientais. 14,1% de 206 jovens relataram fumar cigarros diariamente, enquanto 9,3% dos participantes revelaram fumar cigarros eletrônicos ocasionalmente. Uso de drogas, falta de suporte social, experiências de privação, discriminação, espera para procedimentos médicos de afirmação de gênero e evasão escolar foram associados ao consumo de cigarros entre jovens transgêneros e não-binários brasileiros. Sendo assim, os fatores individuais e contextuais citados devem receber especial enfoque no planejamento de intervenções de prevenção e interrupção do tabagismo voltados a jovens transgêneros e não-binários brasileiros.

Short- and mid- term impact of tobacco smoking on donor renal function following living kidney donation at a tertiary referral hospital

Background: The negative impact of tobacco smoking on renal function has been widely studied. However, there is limited knowledge about the effect of smoking on pre-operative and post-operative renal function in living kidney donors. Objective: The objective of the study was to evaluate the short- and mid-term impact of smoking on donor renal function. Methods: This is a retrospective study of 308 patients who underwent living donor nephrectomy (LDN) at a tertiary referral hospital. We compared baseline characteristics as well as functional outcomes following LDN according to history of tobacco smoking. Estimated glomerular filtration rate (eGFR) was calculated with the modification of diet in renal disease equation in 6 time periods: pre-operative, 1 week, 1 month, 6 months, 12 months, and 24 months after surgery. We performed a Kaplan-Meier analysis for chronic kidney disease (CKD) outcome and binary logistic regression analysis to identify risk factors associated with CKD at 24 months of follow-up. Results: Among donors, 106 (34.4%) reported a smoking history before nephrectomy. Smoking donors had worse pre-operative eGFR than non-smokers (90 ± 26.3 mL/min/1.73m2 vs. 96 ± 27 mL/min/1.73 m2, respectively; p = 0.02) and lower eGFR at 1 week (p = 0.01), 1 month (p ≤ 0.01), 6 months (p = 0.01), and 12 months (p = 0.01) after LDN. Tobacco smoking (OR 3.35, p ≤ 0.01) and age ≥ 40 years at donation (OR 6.59, p ≤ 0.01) were associated with post-operative development of CKD at 24 months after LDN. Conclusions: Living kidney donors with a tobacco smoking history had an increased risk of developing chronic kidney disease following nephrectomy. Smoking-cessation strategies should be implemented.

Ameliorative effect of resveratrol against histological alterations in lung of mice induced by subchronic exposure of cigarette and waterpipe tobacco smoking / Efecto paliativo del resveratrol frente a las alteraciones histológicas en el pulmón de ratones inducidas por exposición subcrónica del tabaquismo de cigarrillos y pipas de agua

SUMMARY: This study aims to evaluate the ability of resveratrol (RSV) antioxidant to attenuate the oxidative stress condition induced by secondhand exposure of cigarettes and waterpipe smoking using animal model. Forty-eight mice were divided equally into six different groups, and RSV was delivered to certain groups intraperitoneally with a dose of 25 mg/kg/day. The process of smoking exposure was performed using a specialized smoking machine. The experiment duration lasts for six consecutive weeks. Five µm sections of lung were stained with hematoxylin and eosin for light microscopy, and 70 nm ultrathin sections of lung stained with uranyl acetate and lead citrate were prepared for transmission electron microscopy to observe the cellular ultrastructure. In lung, RSV reduced the deterioration and blebbing of bronchiole epithelium, reduced the inflammation, increased the surface area of alveolar sac, and reduced the thickening of alveolar walls. Also, blood vessels were less congested and less dilated with less diffusion of extravasated blood. Ultrastructural images illustrated that RSV protects the normal structure of alveolar septum, prevents DNA damage and alveolar degeneration, showed less degree of apical membrane blebbing and retained the uniform pattern of mitochondria. In conclusion, RSV has ameliorative effects against the oxidative stress condition induced by secondhand (side stream) exposure of cigarette and waterpipe tobacco smoking.

RESUMEN: Este estudio tiene como objetivo evaluar la capacidad del antioxidante resveratrol (RSV) para atenuar el estrés oxidativo inducido por la exposición de segunda mano a los cigarrillos y al tabaquismo en pipa de agua, utilizando un modelo animal. Se dividieron cuarenta y ocho ratones en seis grupos diferentes, y se administró RSV a ciertos grupos por vía intraperitoneal con una dosis de 25 mg / kg / día. El proceso de exposición al tabaquismo se realizó utilizando una máquina de fumar especializada. La duración del experimento fue de seis semanas consecutivas. Para realizar la microscopía óptica se tiñeron secciones de pulmón de cinco µm con hematoxilina y eosina, y se prepararon secciones ultrafinas de 70 nm de pulmón teñidas con acetato de uranilo y citrato de plomo para la microscopía electrónica de transmisión para observar la ultra estructura celular. En el pulmón, el RSV redujo el deterioro y la formación de ampollas del epitelio de los bronquiolos, redujo la inflamación, aumentó la superficie del saco alveolar y redujo el engrosamiento de las paredes alveolares. Además, los vasos sanguíneos se encontraron menos congestionados y menos dilatados y con menor difusión de sangre extravasada. Las imágenes ultraestructurales mostraron que el RSV protege la estructura normal del tabique alveolar, previene el daño del ADN y la degeneración alveolar, mostrando un menor grado de formación de ampollas en la membrana apical y además retuvo el patrón uniforme de las mitocondrias. En conclusión, el RSV tiene efectos de mejora contra el estrés oxidativo inducido por la exposición de segunda mano (corriente secundaria) al fumar cigarrillos y pipas de agua.

Why do graphic health warnings fail: An explanatory case study on the persistence of smoking behavior among male adult smokers in a rural and low-income setting in the Philippines

BACKGROUND@#The Philippines enacted in 2014 Republic Act No. 10643 that mandated the printing of Graphic Health Warnings on tobacco packages. However, smoking behavior among male smokers in the country, particularly in rural and low-income areas, persists even if the Graphic Health Warnings are according to the guidelines set by the World Health Organization. Hence, this explanatory case study aims to examine why and how most male adult smokers in a rural and low-income setting in the Philippines fail to quit smoking despite the presence of Graphic Health Warnings on tobacco packages.@*METHODS@#Forty-four male adult smokers from Barangay Urdaneta in Magallanes, Cavite, were recruited to participate in this study through snowball sampling. They underwent semi-structured interviews about their history of smoking, experiences as a smoker, and perspectives on Graphic Health Warnings. Thematic analysis of verbatim transcripts was then carried out to identify emerging themes.@*RESULTS@#Findings showed Graphic Health Warnings fail to persuade against smoking because fear was not aroused enough for smoking cessation. Specifically, the perception of risk from smoking was low due to lack of literacy on its harmful effects, and self-efficacy needed for smoking cessation was low because of self-doubt and denial. Other factors, such as the subjective and social benefits of smoking, were likewise contributory to the persistence of smoking behavior.@*CONCLUSION@#All these concerns must be considered for an effective campaign against tobacco use and consumption since Graphic Health Warnings on tobacco packages is only one strategy to address the burden of tobacco smoking.

Family and contextual factors associated with licit drug use in adolescence

ABSTRACT OBJECTIVE: TO evaluate the family and contextual factors associated with licit drug use among 15 to 19-year-old adolescents in the school context. METHODS: This is a representative, school-based, cross-sectional study conducted with 746 adolescents from 15 to 19 years old enrolled in public and private schools. Parents/guardians reported on the sociodemographic variables, while adolescents answered questionnaires on drug use, family cohesion and adaptability, oral health literacy and visits to the dentist. Information on school context was obtained at the institution and via municipal publications. Associations between variables were analyzed using unadjusted and adjusted multilevel Poisson regression models. RESULTS: Prevalence of licit drug use at least once and a pattern indicative of harmful drug use were 39.8% and 15.1%, respectively. After the adjusted analysis of licit drug use at least once, the variables gender (PR = 1.26; 95%CI: 1.01-1.59), family cohesion (PR = 9.81; 95%CI: 1.23-72.54), and average income of the school district (PR = 0.72; 95%CI: 0.57-0.91) remained in the final model. As for drug abuse, only the detached type (PR = 23.01; 95%CI: 2.46-214.87) and separated type (PR = 13.54; 95%CI: 1.40-130.97) of family cohesion remained in the final model. CONCLUSION: Experience with licit drug use was associated with family and contextual factors among the adolescents, while family cohesion was the main factor related to harmful drug use.

Risk factors of stomach cancer / Монголын Анагаах Ухаан

@#Various studies conducted worldwide emphasized the importance of identifying gastric cancer risk factors for better prevention and further incidence reduction. A total of 52 identified risk factors for gastric cancer were classified into nine categories in which diet, lifestyle, and infections are leading causes. Gastric cancer morbidity and mortality has an increasing trend annually in our country. In Mongolia, only 1% is diagnosed in the carcinoma stage, 3% in the first stage, 11% in the second stage, 43% in the third stage, 42% in the fourth stage. </br> The “Gastric cancer risk factors study, 2018” by L.Tulgaa, and D.Ganchimeg confirmed smoking on an empty stomach as a risk factor. B.Gantuya et al`s (2018) study on gastric cancer and helicobacter infection, as well as S.Tsegmed et al`s (2012) gastric cancer prevalence, its risk factors study, had similar results. </br> B.Gantuya et al (2018) identified the excessive consumption of salt among the gastric cancer diagnosed population in Mongolia. Also, L.Tulgaa and D.Ganchimeg et al`s “Gastric cancer risk factors study, 2018” results reported the daily consumption of salt in tea is a risk for gastric cancer. </br> L.Tulgaa et al`s (2018) study participants had irregular mealtime such as dinners are at a very late hour, the meals aren`t chewed well, leftover meals, and seasoning consumption. These characteristics were significantly different in two groups with a statistically important result. </br> Furthermore, the study results suggested a need to provide practical advice on healthy eating to the population as 50% of the participants consumed more than 5 high-risk food products for esophageal and gastric cancer along with combined risk factors.

Tabaquismo en el adulto mayor: un freno al envejecimiento saludable en la población chilena / Prevalence of smoking among Chilean older people

Background: Smoking is one of the main causes of death among adults worldwide. Aim: To characterize smoking among Chilean older people, according to sociodemographic and clinical variables. Material and Methods: Secondary analysis of data obtained during the National Health Survey 2009-10, selecting individuals aged 60 years and older. Expansion factors were used due to the complex design of the sample. Prevalence and characteristics of smoking were calculated, according to age, sex, educational level, marital status, healthcare insurance system and comorbidities. Results: Nineteen percent of older people were actual smokers, and 85% of these smokers were aged between 60 and 69 years. Forty-five percent were highly dependent to nicotine and 73% reported their intention to quit smoking. Conclusions: There is a high prevalence of tobacco smoking among Chilean older people. Prevention measures are needed.

A study of prevalence of tobacco use and related factors among medical students as per the Global Health Professions Student Survey protocol

Background: Physicians who smoke are less likely to ask patients about their smoking and initiate cessation interventions. Hence it is important to study the prevalence of tobacco use, attitude and training of health professional students. Objectives were to study prevalence and attitudes towards tobacco use and training related to tobacco cessation.Methods: Armed Forces Medical college-based cross-sectional survey by anonymous, self-administered questionnaire as per Global Health Professions Student Survey (GHPSS) was conducted. Data was compiled and analyzed for various variables as per the GHPSS questionnaire.Results: Forty-two percent of the students had ever smoked cigarettes and 24% were current smokers. Nearly one in five had tried their first cigarette before 20 years of age. Male gender was associated with smoking. There is a significant association between not smoking and support for smoking ban in public places. Almost all the respondents (98.1%) thought smoking should be banned in all enclosed public places. In light of 20.6% of all respondents who smoked in college buildings during past this year indicated a gap between their knowledge, attitude and behavior. There was a strong desire to quit smoking but only 42% reported receiving help/ advice to stop smoking. Only one in ten reported receiving formal training in smoking cessation techniques.Conclusions: The fight against tobacco can get a boost through interventions aimed at health care professional students. Active Interventions should be made to address smoking issues among medical students. Skill based medical school curriculum should incorporate and emphasize on acquiring effective smoking cessation skills.

Consejería breve para cesación del consumo de tabaco como estrategia de elección por profesionales de Atención Primaria de Salud de la comuna de Peñalolén / Brief smoking cessation counselling as a choice strategy used by primary health care professionals in a commune of Santiago, Chile

INTRODUCCIÓN: El tabaquismo es una de las pandemias que afecta en mayor proporción a la población mundial. Una de las medidas para controlarlo es la aplicación de consejerías de cesación tabáquica (CCT). OBJETIVO: Determinar y evaluar la técnica de CCT más empleada por profesionales de APS de Peñalolén. METODOLOGÍA: Estudio observacional de corte transversal basado en encuesta y simulación clínica en atención primaria de salud. RESULTADOS: De los 39 participantes, un 55,3% declaró utilizar la consejería breve como CCT y un 42,1% indicó no utilizar ninguna técnica específica. De los 13 profesionales que participaron de la simulación clínica, el 50% incluyó 5 o menos de un total de 7 aspectos claves durante la realización de la consejería breve. CONCLUSIONES: La estrategia de CCT más utilizada por los encuestados es la consejería breve, aunque no siempre se consideran todos los aspectos claves cuando se realiza.

INTRODUCTION: Smoking is one of the pandemics that affects the world's population in a large proportion. One of the measures to control it is the application of smoking cessation counselling (SCC). OBJECTIVE: To determine and evaluate the SCC technique most used by primary health care professionals in Peñalolén a commune of Santiago, Chile. METHODOLOGY: Cross-sectional observational study based on survey and clinical simulation in primary health care professionals. RESULTS: Of the 39 participant professionals, 55.3% declared using brief counselling as SCC and 42.1% indicated they did not use any specific technique. Of the 13 professionals who participated in the clinical simulation, 50% included 5 or less of a total of 7 key aspects during the brief counselling. CONCLUSIONS: Brief smoking cessation counselling is the most used tobacco cessation counselling strategy by the professionals surveyed. Although not all key aspects are always considered when it is done.

The correlation between micronuclei count and smoking behavior: a hospital-based study / Correlación entre recuento de micronúcleos y hábito tabáquico: un estudio hospitalario

Background: Micronucleus is a microscopically visible cyto-plasmic chromatin mass in the extranuclear vicinity, originating from aberrant mitosis, which consists of eccentric chromosomes that have failed to reach spindle poles during mitosis. The present study was designed to evaluate and compare cytogenetic changes in the buccal mucosa of smokers and non-smokers based on the occurrence of micronuclei. The study aimed to determine the correlation between the micronuclei count and the frequency and duration of smoking habit. Materials and Methods: Two groups (smokers and non-smokers) of 34 individuals each were examined. Cytological buccal smears were taken from participants using a moistened wooden spatula and stained with standard Papanicolaou stain. Presence of micronuclei was assessed at 40X magnification using a light microscope and a count per 500 cells was determined. The results of the study were analyzed statistically using Mann-Whitney U test, Spearman's rank correlation coefficient and Student t-test. Result: Smears from smokers showed a significant increase in the total number of micronuclei per 500 cell count compared to non-smokers. There was a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. A age-related increase in older age groups was also observed. Conclusion: The study reveals a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. This observation is vital in the utilization of the micronuclei detection in smears as a prognostic, educational and interventional tool in the management of patients with smoking habits.

Antecedentes: El micronúcleo es una masa de cromatina citoplasmática microscópicamente visible en el área extranuclear, que se origina a partir de la mitosis aberrante, y que consiste en cromosomas excéntricos que no han podido alcanzar los polos del huso durante la mitosis. El presente estudio fue diseñado para evaluar y comparar los cambios citogenéticos en la mucosa bucal de fumadores y no fumadores en función de la aparición de micronúcleos. El estudio tuvo como objetivo determinar la correlación entre el recuento de micronúcleos y la frecuencia y duración del hábito de fumar. Materiales and Métodos: Se examinaron dos grupos (fumadores y no fumadores) de 34 individuos cada uno. Se tomaron frotis bucales citológicos de todos los participantes con una espátula de madera humedecida y se tiñeron con la tinción estándar de Papanicolaou. La presencia de micronúcleos se evaluó al microscopio óptico con un aumento de 40X y se determinó un recuento por 500 células. Los resultados del estudio se analizaron estadísticamente utilizando la prueba U de Mann-Whitney, el coeficiente de correlación de rango de Spearman y la prueba t de Student. Resultados: Los frotis de fumadores mostraron un aumento significativo en el número total de micronúcleos por 500 células en comparación con los no fumadores. Hubo una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. También se observó un aumento relacionado con la edad en los grupos de mayor edad. Conclusión: el estudio revela una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. Esta observación es vital en la utilización de la detección de micronúcleos en frotis como una herramienta pronostica, educativa e intervencionista en el manejo de pacientes con hábitos de fumar.

Smoking among industrial workers in Brazil: association with sociodemographic factors, alcohol consumption, and stress levels / Tabagismo em trabalhadores da indústria no Brasil: associação com fatores sociodemográficos, consumo de bebidas alcoólicas e nível de estresse

ABSTRACT Objective: To determine the prevalence of smoking, as well as its association with sociodemographic factors, alcohol consumption, and stress levels, among industrial workers in Brazil. Methods: This was a nationwide survey, conducted in 24 capitals in Brazil through the application of a pre-tested questionnaire. The response to the question "What is your smoking status?" was the outcome variable. To determine the associations, we performed Poisson regression analyses in which the inputs were blocks of variables: block 1 (age and marital status); block 2 (level of education and gross family income); block 3 (geographic region); and block 4 (alcohol consumption and stress level). All analyses were stratified by gender. Results: The sample consisted of 47,328 workers ≥ 18 years of age, of whom 14,577 (30.8%) were women. The prevalence of smoking was 13.0% (15.2% in men and 7.9% in women). Advancing age, alcohol consumption, and a high stress level were positively associated with smoking. A lower risk of smoking was associated with being married, having a higher level of education, and living in the northeastern region of the country (versus the southern region). Conclusions: The prevalence of smoking was greater in men than in women. Alcohol consumption and high stress levels appear to promote smoking.

RESUMO Objetivo: Determinar a prevalência de tabagismo e sua associação com fatores sociodemográficos, consumo de bebidas alcoólicas e nível de estresse em trabalhadores industriários no Brasil. Métodos: Inquérito nacional realizado em 24 capitais brasileiras através da aplicação de um questionário previamente testado. A variável de desfecho foi obtida através da pergunta: "Com relação ao fumo, qual a sua situação?". Para determinar as associações, foram realizadas análises de regressão de Poisson com entrada de variáveis em blocos: nível 1 (idade e estado civil); nível 2 (escolaridade e renda familiar bruta); nível 3 (região geográfica) e nível 4 (consumo de bebidas alcoólicas e nível de estresse). Todas as análises foram estratificadas por sexo. Resultados: A amostra foi composta por 47.328 trabalhadores com 18 anos ou mais de idade, sendo 14.577 mulheres (30,8%). A prevalência de tabagismo foi de 13,0% (15,2% em homens e 7,9% em mulheres). Aumento da faixa etária, consumo de bebidas alcoólicas e nível de estresse elevado associaram-se positivamente ao tabagismo. Estar casado, ter maior nível de escolaridade e residir na região nordeste do país (quando comparada com a região sul) estiveram associados com menores probabilidades de tabagismo. Conclusões: A prevalência de tabagismo variou entre os sexos, sendo maior entre os homens. O consumo de bebidas alcoólicas e o nível de estresse elevado favoreceram o uso do tabaco.

Dose-Response Association between Smoking Cessation and Arterial Stiffness: The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) Cohort

BACKGROUND AND OBJECTIVES: Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness.METHODS: A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally.RESULTS: The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates.CONCLUSIONS: A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.

Prevalence and factors associated with tobacco use among men in India: findings from a nationally representative data

BACKGROUND@#Tobacco consumption causes almost 638,000 premature deaths per year in India. This study sought to examine the prevalence and determinants of tobacco use among men in India.@*METHODS@#We analyzed data from the fourth round of the National Family Health Survey in India. These nationally representative cross-sectional sample data were collected from January 20, 2015, to December 4, 2016. A total of 112,122 men aged 15-54 years were included in this study. Primary outcomes were tobacco use categorized into smoking, smokeless, any tobacco, and both smoked and smokeless tobacco use. Complex survey design and sampling weights were applied in both the descriptive analyses and logistic regression models. We present the findings using odds ratios.@*RESULTS@#The prevalence of tobacco use among men in India for the studied period was 45.5% (95% CI 44.9-46.1), smoking was 24.6% (95% CI 24.1-25.1), smokeless tobacco use was 29.1% (95% CI 28.6-29.6), and both smoked and smokeless tobacco use was 8.4% (95% CI 8.1-8.7). The prevalence of tobacco use among men was higher among the elderly, separated/divorced/widowed individuals, those with lower education and wealth status, alcohol consumers, manual workers, and residents of the northeast region. Multivariate analysis showed that age, lower education, occupation, region, alcohol consumption, separated/divorced/widowed status, and economic status were substantially associated with tobacco use among Indian men.@*CONCLUSIONS@#Innovative and cost-effective strategies targeting high-risk groups are crucial to curbing the tobacco epidemic in India. Anti-smoking campaigns should also focus on mitigating alcohol abuse. Reducing tobacco marketing and implementing formal education about the dangers of tobacco use, progressive taxing, packaging, and labeling of tobacco products and price strategies should be harmonized in legal provisions.

Frecuencia de factores de riesgo coronarios en pacientes con infarto agudo de miocardio en el Servicio de Cardiología del Hospital de Clínicas

RESUMEN Introducción: el infarto agudo de miocardio es una complicación grave de la enfermedad cardiovascular y se conocen varios factores de riesgo coronarios. Objetivo: determinar la frecuencia de factores de riesgo coronarios en pacientes con infarto agudo de miocardio en el Servicio de Cardiología del Hospital de Clínicas. Material y método: diseño observacional, descriptivo, retrospectivo de corte transversal, que incluyó a pacientes adultos con diagnóstico de infarto agudo de miocardio del Servicio de Cardiología del Hospital de Clínicas desde enero de 2015 a marzo de 2018. Se determinaron las variables demográficas, motivo de consulta, antecedentes familiares de cardiopatía isquémica y la presencia de factores de riesgo coronario. Resultados: se incluyeron 231 sujetos, la edad media fue 63±1 años, 138 (60%) fueron varones. El motivo de consulta más frecuente fue el dolor precordial (71%). La mayoría presentó infarto sin elevación del segmento ST (63,6%). Los factores de riesgo coronario más frecuentes fueron la hipertensión arterial (89%), el sedentarismo (60%) y el consumo de tabaco (55,4%) sobre todo en los pacientes mayores de 65 años. Conclusión: los factores de riesgo coronario más frecuentes fueron la hipertensión arterial, el sedentarismo y el tabaquismo, predominando en mayores de 60 años.

ABSTRACT Introduction: Acute myocardial infarction is a serious complication of cardiovascular disease and several coronary risk factors are known. Objective: To determine the frequency of coronary risk factors in patients with acute myocardial infarction in the Cardiology Service of the Hospital de Clínicas. Material and method: Observational, descriptive, retrospective cross-sectional design which included adult patients diagnosed with acute myocardial infarction from the Cardiology Service of the Hospital de Clínicas from January 2015 to March 2018. Demographic variables, reason of consultation, family history of ischemic heart disease and the presence of coronary risk factors were determined. Results: Two hundred thirty-one subjects were included, the mean age was 63±1 years, and 138 (60%) were male. The most frequent reason for consultation was precordial pain (71%). The majority presented infarction without elevation of the ST segment (63.6%). The most frequent coronary risk factors were arterial hypertension (89%), sedentary lifestyle (60%) and tobacco consumption (55.4%), especially in patients older than 65 years. Conclusion: The most frequent coronary risk factors were arterial hypertension, sedentary lifestyle and smoking, predominating in people over 60 years of age.

Association of oral pre-malignant lesions with the consumption of tobacco

Background: Tobacco consumption in the form of chewing and smoking is one of the biggest addictions. It causes various oral pre-malignant lesions which mainly include oral sub-mucous fibrosis (OSMF) caused by betel nut consumption and tobacco quid lesion, leukoplakia, erythroplakia and smoker's palate caused by chewing and smoking tobacco. Methods: The data about the past and present consumption of tobacco was collected from 909 individuals. Based on the tobacco habits, the oral cavity findings were assessed and the statistical analysis was carried out to find the significance of associations observed between tobacco consumption and lesions. Results: Out of 909 subjects, 537 were consuming tobacco, out of which 284 were chewers, 65 were smokers and 76 were consuming in both forms. Out of the 284 tobacco chewers, 43% had oral lesions (19.4% had OSMF and 21.5% had tobacco quid) as compared to just 1% of workers having oral lesions (OSMF) amongst those who had no addiction. There was a high prevalence of lesion in tobacco chewers (p<0.005). Out of total smokers, 15.8% had smoker's palate whereas no lesion was seen in the non-addicted workers. The odds of developing oral pre-malignant lesion are 43.62 times higher in exposed individuals. Conclusions: The tobacco consumption in any form is hazardous. Betel nut exposure causes more harmful effect which goes unnoticed. Awareness should be created about various lesions caused by tobacco as well as betel nut and special steps should be taken for early diagnosis and its treatment.